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There is much evidence to suggest that psychotherapy is effective, however, it is far from flawless (e.g., Lilienfield, 2007; Stuart, 1970). As the field of mental health changes, there has been a recent movement in routine practice toward the use of standardized measures to track client progress and to collect feedback about treatment response (Lambert & Shimokawa, 2011). The use of standardized tools can help practitioners identify when clients are not progressing in therapy and have been linked to better outcomes for nonresponsive clients than when these measures are not used (e.g., Shimokawa, Lambert, & Smart, 2010). The purpose of this article is to introduce a group of such tools, referred to as progress monitoring (PM) measures, and to highlight features relevant in selecting and implementing a PM measure in practice. Areas covered include domains assessed, target populations, administration, scoring, feedback and interpretation, cost, training and privacy. While there exist numerous outcome and assessment measures (e.g., Froyd, Lambert, & Froyd, 1996), this article focuses specifically on seven popular progress monitoring measures for adult mental health populations, that are brief, comprehensive and easily accessible tools designed to be used to monitor change throughout the therapeutic process.
Keywords: psychotherapy, progress monitoring (PM) measures, feedback, outcome, progress tracking
Research suggests that 5-10% of clients in psychotherapy experience deterioration, and up to 50% demonstrate no reliable change during treatment (Hansen, Lambert, & Forman, 2002; Lambert & Ogles, 2004). As clinicians do not accurately detect when clients are worsening (Hannan et al., 2005; Hatfield, McCullough, Frantz, & Krieger, 2010), it may be important to supplement clinical judgment with additional tools. Tools that can help clinicians identify clients who are not responding to treatment and that improve therapeutic outcomes may be referred to as progress monitoring (PM) measures. These measures are used to carry out continuous assessment of client change and to give the clinician systematic feedback about treatment response (Lambert & Shimokawa, 2011). In contrast to pre-post assessments, PM measures are completed by the client on a routine basis, and feedback is provided to the clinician throughout the therapeutic process.
The practice of tracking client change during therapy has been studied by research teams around the world and is referred to in varying ways, including Client-Directed, Outcome-Informed therapy (CDOI;...